Deep learning-based image reconstruction improves radiologic evaluation of pituitary axis and cavernous sinus invasion in pituitary adenoma. Issue 158 (January 2023)

• Record Type: Journal Article
• Authors: Park, Hyeryeong; Nam, Yeo Kyung; Kim, Ho Sung; Park, Ji Eun; Lee, Da Hyun; Lee, Joonsung; Kim, Seonok; Kim, Young-Hoon
• Is Part Of: European journal of radiology. Issue 158(2023)
• Publication Date: 2023-01
• Subjects: Deep learning-based reconstruction -- Pituitary adenoma -- Cavernous sinus -- Stalk -- Gland; 1-mm DLR 1-mm thickness MRI using deep learning-based reconstruction -- 3-mm routine 3-mm thickness routine MRI -- CS cavernous sinus -- TSA transsphenoidal approach -- SNR signal-to-noise ratio; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2022.110647
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: Deep-learning based reconstruction (DLR) improves detection of cavernous sinus invasion for pituitary adenoma. Inexperienced readers preferred 1 mm-DLR over 3-mm routine MRI for delineation of pituitary adenoma and pituitary stalk. DLR provides higher signal-to-noise ratio compared with routine MRI. Abstract: Purpose: To compare performance of 1-mm deep learning reconstruction (DLR) with 3-mm routine MRI imaging for the delineation of pituitary axis and identification of cavernous sinus invasion for pituitary macroadenoma. Method: This retrospective study included 104 patients (59.4 ± 13.1 years; 46 women) who underwent an MRI protocol including 1-mm deep learning-reconstructed and 3-mm routine images for evaluating pituitary adenoma between August 2019 and October 2020. Five readers (24, 9, 2 years, and <1 year of experience) assessed the delineation of pituitary axis (gland and stalk) and the presence of cavernous sinus invasion for using a pairwise design. The signal-to-noise ratio (SNR) was measured. Diagnostic performance as well as image preference data were analysed and compared according to the readers' experience using the McNemar test. Results: For delineation of normal pituitary axis, all readers preferred thin 1-mm DLR MRI over 3-mm MRI (overall superiority, 55.8 %, P <.001), with this preference being greater in the less experienced readers (92.3 % vs. 55.8 % [expert], P <.001). The readers showed higher diagnostic performance for cavernous sinus invasion on 1-mm (AUC, 0.91 and 0.92) than on 3-mm imaging (AUC, 0.87 and 0.88). The SNR of the 1-mm DLR was 1.21-fold higher than that of the routine 3-mm imaging. Conclusion: Deep learning reconstruction-based 1-mm imaging demonstrates improved image quality and better delineation of microstructure in the sellar fossa and is preferred by both radiologists and non-radiologist physicians, especially in less experienced readers.